KNOWLEDGE, PERCEPTION AND ACCEPTANCE OF COVID – 19 VACCINE AMONG HEALTH WORKERS IN PRIMARY AND SECONDARY HEALTH INSTITUTION IN NIGERIA
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CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
COVID-19 (The Coronavirus Disease 19) pandemic caused serious disturbance in a remarkable challenges for healthcare systems worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causative of severe viral pneumonia that started in Wuhan, China in December 2019, has infected more than 120 million people and resulted in 2.66 million deaths as of March 16, 2021 Guan WJ, et al., (2019). COVID-19 mainly affects the respiratory system with diverse symptoms from mild rhinorrhea to severe respiratory distress syndrome Huang C et al., (2019). This virus is majorly more lethal for the elderly and those with history of concomitant, such as hypertension, obesity, diabetes, and kidney disease (Grasselli, 2020).
African healthcare systems are not fully-equipped to handle this pandemic (Elhadi, 2020). While African countries are at a higher risk of disease spread due to inadequate health infrastructure and training, their inability to directly obtain the vaccine further increases the risk of disease spread. Most developed countries did not just order for most of the vaccine supplies, but vaccine-related costs and transfer issues may also further delay vaccination procedures for African people as far as late 2021 or early 2022.
The first COVID-19 case, occurred in Libya and was reported on March 24, 2020. However, the pandemic has spread rapidly here since then, resulting in more than 146,000 cases and 2402 deaths as of March 16, 2021. The, Libya’s healthcare system was not prepared for this pandemic and continues to suffer from serious issues such as shortage of personal protective equipment, lack of healthcare training, unavailability of testing centers in many cities, and shortage of healthcare center funding due to the ongoing civil war conflict and financial crisis; these factors have resulted in several unprecedented financial, psychological, and social challenges for healthcare workers (Elhadi M, et al., 2020).
Over the years, vaccinations have been seen as the best method to control rapidly spreading infectious diseases. Most groups and individuals has recently started to spread rumors and conspiracy theories aimed against vaccination, intensifying the pressure on healthcare authorities and workers, Paterson P, et al., (2016). COVID-19 vaccine development and supply is an ongoing process; currently, in Europe and North America, several candidate vaccines from well-known companies have been released for healthcare workers and high-risk populations such as the elderly and patients with chronic diseases (Voysey M, et al., 2021). Low- and middle-income countries are at greater risk of vaccination delays due to several reasons: lack of public trust, shortage of resources, and scarcity of vaccination supply as many high-income countries secure a large amount of the new vaccines, without prioritizing other countries. Therefore, this disparity can leave low- and middle-income countries at a disadvantage, given their low ability to fight COVID-19 with their current status of healthcare system, leading to humanitarian crises (Elhadi et al., 2020).
Partnership by several companies and their initiatives announced in September 2020 aimed at supplying 100 million doses of COVID-19 vaccine to low- and middle-income countries in 2020. To achieve the necessary herd immunity to control viral transmission and stop the pandemic, vaccinating more than 82% of the population is vital and requires strong acceptance and low dithering levels throughout the population (Sanche et al., 2020). Therefore, identifying factors associated with vaccine acceptance and hesitancy is needed to implement policy changes and help public health experts identify a conceptual framework and educational campaign aimed at increasing this awareness in the general population (Wong MCS, et al., 2021).
Dwindling public confidence in vaccines due to rumors and conspiracy theories is a major challenge for public health experts and policymakers worldwide (Kumar D, et al., 2016). Delays, spreading rumors, and fake news can affect public mentality and vaccine decisions. A known example is the 2003–2004 Nigerian boycott of the polio vaccine that resulted in a surge of the disease (Ghinai, et al., 2013). Hence, social endorsement and efforts against hesitation regarding the COVID-19 vaccination are essential, especially in limited-resource settings. This will go a long way in promoting vaccination and establish trust between the general population and health authorities and policymakers, leading to better control of the pandemic and a reduction of lives lost. Therefore, ascertaining vaccine acceptance and hesitation among the general population and healthcare workers is important to draw policy plans and assess available resources to meet COVID-19 and overall health challenges to lessen the acute pandemic burden. This study will determined the knowledge, perceptions, and acceptance of COVID-19 vaccine among Health workers in Primary and Secondary Health Institution in Sapele LGA, Delta, Nigeria.
INFLUENCE OF RADIO MESSAGES ON COVID-19 PANDEMIC AWARENESS
1.2 Statement of the Problem
Healthcare workers play an important role in immunization program success and research has shown that their knowledge and attitudes in relation to vaccines determine their intentions for vaccine uptake and their recommendation of the vaccine. Healthcare workers can themselves be vaccine hesitant and their hesitancy levels can thus impact hesitancy and aversion to receiving the vaccine among the general public. Additionally, it has been reported that healthcare workers who have negative attitudes, are averted, or are hesitant about vaccinations share these unfavorable attitudes and tend to recommend vaccination to their patients infrequently. The Healthcare Workers are at the frontline of COVID- 19 pandemic defense and are exposed to, not only infection with COVID-19 due to their frequent exposure to infected individuals, but also psychological distress, long working hours, fatigue, occupational stigma and physical violence. Research studies assessing the uptake of seasonal and/or pandemic influenza vaccines among healthcare workers found that vaccine acceptance among this population is low. Various factors were found to underlie this behavior, which include low perceived benefits, low perceived risk of infection, fear of side effects and concerns surrounding safety and efficacy. Given the significant role of vaccinated healthcare workers on shaping the general population’s decisions to vaccinate, and as the availability of the vaccine does not necessarily translate into its adoption, this study thus aims to determine the COVID-19 vaccine’s acceptability among healthcare workers in the Sapele LGA and to identify the factors affecting their intention to accept it. The largest burden of this COVID-19 infection and deaths occurs mainly in developing countries. Knowledge and awareness this disease, remains a major challenge in Sapele LGA, Delta, Nigeria. Due to the mortality rate attributable to COVID-19 in Nigeria and the world at large, this study was carried out to determine the knowledge perceptions and acceptance of COVID-19 vaccine among Health workers in Primary and Secondary Health Institution in Sapele LGA, Delta, Nigeria.
1.3 Aims/Objectives of the Study
The primary aim of this study is to determine the knowledge, perceptions and considering the rate of acceptance of COVID-19 vaccination among healthcare workers in Primary and Secondary Health Institution in Sapele LGA. The specific objectives are:
- To ascertain the causes of Health worker’s refusal of COVID-19 vaccination in Primary and Secondary Health Institution in Sapele LGA, Delta, Nigeria.
- To identify the needed strategies to be implemented to improve vaccine acceptance among healthcare workers in Sapele LGA, Delta, Nigeria.
- Estimating the rate of acceptance of COVID-19 vaccination among healthcare workers.
1.4 Significance of the Study
The researcher anticipates that at the completion of this study, it will give a clear insight on the knowledge, and perceptions among Health workers in Health Institutions in Sapele LGA.
This finding is significant since psychosocial factors such as perceptions, emotions, trust in vaccines, and trust in vaccine providers have been found to contribute to vaccine hesitancy and refusal and may have played a role in vaccine acceptance among these health workers.
This study will provide insightful information on educational awareness about COVID-19 infection and vaccination that can be implemented via an applicable framework of governmental public health efforts. Health literacy and awareness greatly influence intention to act upon health recommendations, which is crucial to avoid such negative consequences of the pandemic, such as waste disposal of protective gear and restrictive hygienic practices aimed to reduce the COVID-19 public health burden.
It will provides valuable data for policymakers to plan vaccination programs and tackle the challenges identified in the study.
1.5 Research Questions
To achieve the objective of this study, the following questions are formulated:
- What are the causes of Health worker’s refusal to COVID-19 vaccine in Sapele LGA, Delta, Nigeria?
- What are the strategies to be implemented to improve vaccine acceptance among healthcare workers in Sapele LGA, Delta, Nigeria?
- What are the rate of acceptance of COVID-19 vaccination among healthcare workers?
1.6 Scope of the Study
Since the statement of problem in this study affects the entire local government areas in Delta State, and the dynamic scope also have a national outlook. It will be ideal to embark on the study in the entire local government areas in Delta State. And since no single research can validly cover all areas of the topic, this study will be based on a comprehensive study of the knowledge, perception and acceptance of Covid – 19 vaccine among Health workers. However, it becomes necessary for the researcher to narrow it down to primary and secondary Health institution in Sapele LGA to enable the researcher carryout out extensive investigation on the subject.
1.7 Limitations of the study
The main limitation of this study was that it was conducted only one Local Government and this may limit the extent to which the results can be generalized.
A cross-sectional, descriptive study design was used in this study with the advantages that the study has several outcomes, has control over measurements with a short duration, could yield prevalence, and is relatively quick and inexpensive. Its disadvantages are that it gave a background on the perception and vaccine acceptance of COVID-19 vaccination among healthcare workers in a certain period during this study.
Lack of representation of all Healthcare Workers in all health Institution in Sapele LGA, some Healthcare Workers in fever and insurance hospital weren’t represented, using google form to collect part of our sample via internet.
1.9 Definitions of Concepts
In order to clarify the concepts used in this study, the following definitions are provided:
Knowledge: is the expertise and skills acquired by a person through experience or education in the theoretical or practical understanding of a subject, in this case the knowledge of EBF. Knowledge in this study is defined as the information or understanding of education received by HIV-positive women (Thomson et al. 2018).
Perceptions: the ability to see, hear, or become aware of something through the senses. The neurophysiological processes, that includes memory, in which an organism becomes aware of and interprets external stimuli.
Acceptance: the action of consenting to receive or undertake something offered.
Health: a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
Institution: a facility or establishment in which people (such as the sick or needy) live and receive care typically in a confined setting and often without individual consent.
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